Health-risk Perception in the Inner City Community of Centro Habana, Cuba

Abstract

Perceptions of health risks were surveyed in the inner city of Centro Habana, Cuba. A questionnaire developed by community leaders and experts was administered to 348 residents to determine the level of perceived risk for each of 41 risk items. Ecologic-level data on morbidity, mortality, and environmental indicators were also gathered. Using factor analysis to reduce the dimensionality of the data, five factor groupings accounted for 60% of the variance, as follows: social environment (40.8%); infectious agents and other health-risk factors of immediate concern (6.1%); lifestyle risks (4. 9%); environmental sanitation (4.1%); and living conditions (3.3%). A relationship between the perception of risk and the ecologic data was found, with inconsistencies largely attributable to factors known to influence risk perception. The greatest concern identified throughout the municipality was housing conditions, highest in the neighborhood that had already begun to address this problem. The analysis was useful in planning targeted health promotion campaigns and prioritizing further interventions. Repeat evaluation of risk perception will be conducted following the completion of interventions.

Building Capacity in Central Havana to Sustainably Manage Environmental Health Risk in an Urban Ecosystem

“…Greater improvements in housing, local infrastructure, and exposure to risk were perceived to have occurred in the targeted community, more so from the perspective of benefit to the community than with regard to the residents' own households (see Fernández et al, 2000;Spiegel et al, 2003;Tate et al, 2003). Improvements in some lifestylerelated risk factors and self-rated health in the most vulnerable subgroups (such as elderly women and young people under age 20) were also achieved.…”

“…This collaborative ecosystem health research project proceeded from the premise that constituent elements of urban ecosystems (quality of housing, water and waste disposal systems, cultural and social programs), and characteristics at the individual and family level, are important factors influencing the well-being of the community. In the course of very intensely working with the community-in all phasesfrom understanding their needs in a pre-intervention risk perception survey (Fernández et al, 2000), to working with the community in meetings and a series of workshops to develop indicators of relevance to them (Spiegel et al, 2001a), to using and discussing these indicators to evaluate the success of the interventions and how risk perception had changed subsequent to the intervention , the community became familiar with this framework. Moreover, the study of how the community had actually participated in both the implementation of the intervention and the research , led to insights on what could have been done better.…”

“…There has been widespread dissemination of the results-to the community (community leaders, health decision-nakers, health workers, and the scientific community) to improve human health through better ecosystem management in Central Havana and elsewhere (Yassi et al, 1999Fernández et al, 2000;Bonet et al, 2001;Spiegel et al, 2001a, b,;2002a, b;Tate et al, 2001Tate et al, , 2003and others) and interest has been expressed for similar processes in other communities.…”

“…Also, before the intervention (in 1995), 365 adults had been surveyed regarding their risk perception regarding 41 health determinants-with factor analysis conducted to reduce the dimensionality of the data-resulting in five factors: social environment, environmental sanitation, lifestyle factors, threats to personal health, and safety, and housing (Fernández et al, 2000). In the course of the household survey conducted following the intervention (conducted in 2000), risk perception regarding the same 41 determinants were surveyed again, and factor analysis conducted.…”

The World of Open Access Journals

“…Findings regarding the effectiveness of the interventions with respect to changing perceptions of health risk [49][50][51] and improving health indicators and satisfaction 52,53 are reported elsewhere, as is an analysis of social capital and its relation to health in Central Havana. 54 The purpose of this article is to provide an overview of the implementation of the Cayo Hueso Plan and lessons learned about community participation.…”